Pathological and biological analyzes of angiogenesis on urological cancers

实体瘤的生长本质上需要多种血管生成因子调控的新生血管形成。免疫组织化学和生物遗传学研究表明，血管内皮生长因子和碱性成纤维细胞生长因子在实体瘤的生长过程中起着不可或缺的作用。为探讨肾细胞癌患者血清中血管内皮生长因子和成纤维细胞生长因子-2水平作为肿瘤标志物的价值，采用双抗体夹心酶联免疫分析法检测40例肾细胞癌患者和40例非肿瘤患者外周血中血管内皮生长因子和成纤维细胞生长因子-2水平。20例肾细胞癌患者均取双侧肾静脉血标本。6例患者在根治性肾切除术前、术后4周和3例病情进展时检测血清血管内皮生长因子水平。肾细胞癌患者血清血管内皮生长因子水平显著高于对照组(207.3士.+-)。[)32.9对71.5()SY+-。[9.1pg/ml，p&lt；0.005)，而肾细胞癌患者血清成纤维细胞生长因子-2水平与正常对照组(14.4pg/ml)无显著差异(P>0.05)。[)1.9对14.7(SY+-)。[)3.0pg/ml)。以100pg/ml为临界值，ROC曲线判断血清VEGF的敏感性为80.0%，特异性为72.5%。20例患者中，有17例(85%)患肾肿瘤患者血清VEGF水平高于对侧正常肾。血清血管内皮生长因子水平与肿瘤体积、肿瘤范围、有无转移等肿瘤状态显著相关。6例肾癌根治性切除患者中5例血清VEGF水平降低，3例肿瘤进展患者血清VEGF水平均升高，提示肿瘤组织自身分泌的VEGF水平可作为肾细胞癌的候选标志物，其表达水平较FGF2更能反映肿瘤的状态。

Solid tumor growth essentially requires neovascularization regulateted by various angionenic factors. Vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (FGF-2) are considered to play an inevitable role in growth of solid tumors, as indicated by immunohistochemical and biogenetic procedure. We investigated the usefulness of serum VEGF and FGF-2 levels in RCC patients as a tumor marker for RCC.Serum levels of VEGF and FGF-2 in peripheral blood samples were analyzed in 40 patients with RCC and 40 noncancerous patients (control) using sandwich enxyme-linked immunoassay (EIA). In 20 RCC patients, serum samples were obtained from bilateral renal veins. Serum VEGF levels were also measured before and 4 weeks after radical nephrectomy in 6 patients, and at the time of diagnosis of diseasem progression in 3.The serum VEGF level in RCC patients were significantly higher than that in the control (207.3(]SY.+-。[)32.9 vs.71.5(]SY.+-。[)9.1pg/ml, p<0.005), while no significant difference was observed in the serum FGF-2 level between RCC patients and the control (14.4(]SY.+-。[)1.9 vs.14.7(]SY.+-。[)3.0 pg/ml). The sensitivity and specificity of serum VEGF at a cut-off level of 100pg/ml, given by ROC curve, were 80.0% and 72.5%.respectively. The serum VEGF level of the tumor-bearing kidneys was higher than that of the contralateral normal kidneys in 17 (85%) of 20 patients. The serum VEGF level significantly correlated with the tumor status such as tumor volume, tumor extent and existence of metastasis. A decreased serum VEGF level was detected in 5 of 6 patients after radical nephrectomy and an increase in all 3 patient with tumor progressions.The present results suggest taht VEGF is secreted by the tumor tissue itself and its serum level could be a candidate marker for RCC which reflects the tumor status better than that of FGF-2.